Objective To study the correlation of an ultra high performance liquid chromatography(UPLC)fingerprint of Xiaochengqitang pieces(decoction and granules).Methods The UPLC method was used to establish the fingerprint of 15 batches of Xiaochengqitang pieces(decoction and granules).The correlation of the three UPLC fingerprints was evaluated by similarity analysis,pearson correlation analysis,cluster analysis(CA),principal component analysis(PCA)and orthogonal partial least squares-discriminant analysis(OPLS-DA).Results UPLC fingerprints of 15 batches of Xiaochengqitang pieces(decoction and granules)determined 16 common peaks,and 14 peaks were identified.The similarity of the fingerprints of the 15 batches of Xiaochengqitang pieces(decoction and granules)with the corresponding control fingerprints was greater than 0.90,and the similarity of the three control fingerprints was greater than 0.88.The results of pearson correlation analysis showed that 8 common peaks in Xiaochengqitang pieces(decoction and granules)had a very significant positive correlation.The results of CA showed that the properties of Xiaochengqitang decoction and granules were more similar.The results of PCA showed that the principal components with 4 eigenvalues greater than 1 contained 88％of the information of the original data.OPLS-DA screened 7 differential markers with variable importance projection value greater than 1.Conclusion The main chemical compositions of Xiaochengqitang pieces(decoction and granules)are consistent,which can provide data support for the quality control and clinical use of Xiaochengqitang compound preparation.

Objective To explore the effects of exposure to lipopolysaccharides in late pregnancy on age-related cognitive changes in offspring of mice,and to investigate whether there is a gender specific genetic effect.Methods Institute of cancer research(ICR)CD-1 mice during gestational days 15-17 were injected with lipopolysaccha-ride daily(LPS group,50 μg/kg),or equal volume of normal saline(CON group).At the age of 2 months after their delivery,LPS treated offspring mice(F1-LPS,male and female)were randomly selected and hybridized with age-matched wild-type CD-1 mice.F1-LPS males and females with different littermates,and F1-CON males and fe-males were hybridized to obtain F2 generations of different lineages.Similarly,F2-LPS mice were mated with wild-type mice to conceive the F3 generation.At the age of 3 and 18 months old,F1,F2,and F3 mice(n=8 in each group)were randomly selected to complete the Morris maze experiment in order to test their cognitive abilities.Re-sults Compared with 3-month-old CON mice,18-month-old CON mice showed poorer learning and memory abili-ties,especially in females.For Fl generation,the learning and memory abilities of the 3-month-old and 18-month-old F1-LPS mice were inferior to those of the same aged CON mice.For F2 generation,the 3-month-old F2-LPS-parental mice had poorer learning and memory compared to the same aged CON mice,while the F2-LPS-paternal mice only had poorer memory compared to the same aged CON group.The learning and memory abilities of 18-month-old F2-LPS paternal and F2-LPS-parental mice were inferior to those of the same aged CON mice.The learn-ing and memory abilities of F2-LPS maternal male mice were inferior to those of CON male mice,and the memory abilities of F2-LPS maternal mice were stronger than those of F2-LPS-parental mice.With regards to the F3 genera-tion,the memory of the 3-month-old F3-LPS-parental mice was poorer than that of the same aged CON mice.The learning and memory abilities of F3-LPS paternal and F3-LPS-parental mice at 18 months old were inferior to those of CON mice of the same age.The 18-month-old F3-LPS maternal and paternal male mice had better memory than F3-LPS-parental male mice.Conclusion Exposure to lipopolysaccharides in late pregnancy can accelerate age-re-lated cognitive decline in offspring mice,and it has a cross generational genetic effect and gender differences,mainly in paternal inheritance.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To investigate the feasibility of blue velvet arena test (BVAT) in evaluating spatial memory function in patients with chronic insomnia disorder (CID).Methods:From June 1, 2021 to May 31, 2022, 62 CID outpatients or inpatients were enrolled continuously in the Department of Sleep Disorders, the Affiliated Chaohu Hospital of Anhui Medical University, and 56 good sleepers in the same period were enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. Montreal Cognitive Assessment Scale (MoCA), nine box maze test (NBMT), and BVAT were used to assess general cognition and memories.Results:Compared to the controls, the CID patients had increased PSQI score [15.0 (12.8, 16.0) vs 0 (0, 1.0); Z=-9.47, P<0.001], and decreased MoCA score [24.5 (21.5, 27.0) vs 27.0 (26.0, 28.0); Z=-4.18, P<0.001]; increased numbers of errors in the spatial working [1.0 (0.8, 2.0) vs 1.0 (0, 1.0); Z=-2.24, P<0.05], object working [1.5 (0.8, 3.0) vs 0 (0, 1.0); Z=-4.36, P<0.001] and object recognition [0 (0, 0) vs 0 (0, 0); Z=-2.10, P<0.05] memories in NBMT; and increased average erroring distance in BVAT [23.0 (16.4, 27.2) cm vs 18.7 (16.6, 20.7) cm; Z=-3.30, P<0.01]. Partial correlation analysis showed that in the CID patients, the average erroring distance in BVAT was positively correlated with erroneous numbers in spatial working memory in NBMT ( r=0.54, P<0.001). Principal components analysis showed that the average erroring distance of BVAT (load=0.844) and the errors of spatial working memory in NBMT (load=0.801) were jointly attributed to the first factor. Receiver operating characteristic curve analysis showed that the sensitivity of BVAT was higher than that of NBMT (0.575 vs 0.250, P<0.05) for spatial memory detection in total sample. Conclusion:The BVAT has a higher reliability in the functional assessment of spatial memory in CID patients.

Confusional arousal (CA) is a rare non-rapid eye movement sleep-related parasomnia and rarely reported in China, leading to misdiagnosis and mistreatment in clinic. A detailed collection of clinical symptoms and simultaneous video polysomnography is very important for diagnosis and differential diagnosis of CA. A elderly patient with CA was diagnosed according to the International classification of sleep disorders, third edition diagnostic criteria. The summary and analysis of the patient is conducted to improve the understanding of CA, meanwhile to avoid misdiagnosis and mistreatment.

Objective: To investigate the effects of embryonic inflammation on the hippocampal synaptosomal-associated protein 25(SNAP-25) level and cognitive function in middle-aged. Methods: During gestational days 15-17, the CD-1 maternal mice received a daily intraperitoneal injection of lipopolysaccharides(LPS, 50 μg/kg) or the equal volume of normal saline, and the corresponding offspring were regarded as LPS group and CON group respectively. At the age of young(3-month-old) and middle-aged(15-month-old), the spatial learning and memory ability was assessed using Morris water maze(MWM), and the expression of hippocampal SNAP-25 protein was detected by immunohistochemical method and Western blot. Results: Compared with the 3-month CON group, the 15-month CON group had longer swimming distance(P<0.01), lower swimming distance percentage(P<0.01) in the target quadrant, and higher hippocampal subregions(CA1, CA3, DG) SNAP-25 levels(P<0.01). The same results were obtained in 15-month LPS group compared with 15-month CON group in learning and memory phase(P<0.05), and higher hippocampal subregions(CA1, DG) SNAP-25 levels(P<0.01). Pearson correlation analysis indicated that the hippocampal CA1 and CA3 subregions SNAP-25 level was positively correlated with the swimming distance, but negatively correlated with the percentage of swimming distance in the target quadrant. Conclusion Embryonic inflammation can accelerate the impairment of spatial learning and memory and the increase of hippocampal CA1 and CA3 subregions SNAP-25 protein in middle-aged CD-1 mice, and there may be a correlation between them.

Objective: To explore whether long-term potentiation(LTP) induced by brain-derived neurotrophic factor(BDNF) of hippocampus is involved in the process of maternal separation(MS) leading to impaired cognitive function of offspring in adolescence. Methods: The newborn CD-1 mice were randomly divided into maternal separation group(MS group) and control group(CON group). Mice in MS group were separated from the mother mice for 3 h every day from postnatal day 4 to 21 while no intervention was taken in the CON group. The spatial learning and memory ability was assessed using Morris water maze at the age of 3 months. Western blot and real-time quantitative PCR were used to detect the levels of BDNF and BDNF mRNA in the hippocampus. LTP of the hippocampal CA3-CA1 neural pathway was recorded using electrophysiological techniques. Results: Compared with CON group, the latency and distance of Morris water maze in maternal separation group were significantly longer(P<0.01). The percentage of time and distance in target quadrant during the memory phase in MS group were obviously lower than those in control group(P<0.05). The results of WB and Real-time quantitative PCR in MS group showed that the levels of BDNF and BDNF mRNA in MS group apparently decreased(P<0.05). Compared with CON group, MS group showed a significantly lower LTP in CA3-CA1 neural pathway(P<0.01). Conclusion The certain intensity of maternal separation can impair learning and memory function in young CD-1 male mice, which may be associated with decreased expression of BDNF and impaired LTP in the hippocampus.

Objective:To explore the changes of serum levels of copeptin and α-amylase and their correlations with sleep and cognition in patients with chronic insomnia (CI).Methods:From September 1, 2018 to May 31, 2019, fifty CI outpatients or inpatients from the Department of Sleep Disorder, Affiliated Chaohu Hospital of Anhui Medical University, were enrolled continuously, and thirty good sleepers from the Physical Examination Center of the hospital, were also enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG) and Pre-Sleep Arousal Scale (PSAS) were used to assess the insomnia severity and sleep disorder susceptibility. Montreal Cognitive Assessment scale (MoCA) and Nine-Box Maze were used to respectively assess general cognition and memories. The serum levels of copeptin and α-amylase were detected using enzyme linked immunosorbent assay.Results:Compared to the controls, the CI patients had increased PSQI score (16.0 (15.0, 17.0) vs 4.0 (2.8, 6.0); Z=-7.678, P<0.001) and PSAS score (33.0 (30.0, 37.5) vs 17.0 (16.0, 18.5); Z=-7.350, P<0.001), decreased MoCA score (24.1±2.5 vs 26.7±1.9, t=-4.625, P<0.001), increased numbers of errors in the object working (1.0 (0, 1.0) vs 0 (0, 1.0), Z=-2.099, P=0.036), spatial working (2.0 (1.0, 4.0) vs 1.0 (0, 2.0), Z=-3.935, P<0.001) and object recognition (1.0 (0, 2.0) vs 0 (0, 0), Z=-2.266, P=0.023) memories, and elevated serum levels of copeptin ((35.1±19.9) pg/ml vs (14.8±6.9) pg/ml, t=5.414, P<0.001) and α-amylase ((990.1±193.7) U/L vs (728.9±230.5) U/L, t=5.597, P<0.001). In the CI patients, the level of copeptin was positively correlated with PSQI score ( r=0.338, P=0.013), PSAS score ( r=0.316, P=0.021), sleep latency ( r=0.324, P=0.018), number of awake ( r=0.325, P=0.017) and stage 1 percent of non-rapid eye movement sleep ( r=0.278, P=0.044), and negatively correlated with stage 2 percent of non-rapid eye movement sleep ( r=-0.279, P=0.043); α-amylase was positively correlated with numbers of awake in PSG ( r=0.293, P=0.033). Multiple linear regression analysis showed that copeptin level affected PSQI score (β=0.255, P=0.043) and sleep latency (β=0.254, P=0.043). Conclusion:The levels of copeptin and α-amylase in CI patients elevate, and copeptin may be associated with initial sleep difficulties, but not with cognitive ability, in patients with CI.

Objective: To explore serum levels of brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF), and whether changes of BDNF and GDNF are correlated with sleep quality and cognitive function in patients with chronic insomnia disorder (CID). Methods: Fifty-seven CID patients in the Department of Sleep Disorders, Chaohu Hospital of Anhui Medical University and 30 healthy controls were enrolled from May 2017 to July 2018. Pittsburgh Sleep Quality Index (PSQI) was used to assess the degree of insomnia severity (some CID patients were monitored by overnight polysomnography). Montreal Cognitive Assessment (MoCA) scale and Nine-Box Maze were used to assess general cognitive function and specific memory function, respectively. The serum levels of BDNF and GDNF were detected using ELISA. Results: Compared to the controls, CID patients had significantly higher PSQI scores (CID patients: 14.0±2.2, healthy controls: 3.9±1.1; t=28.093, P<0.01), lower MoCA scores (CID patients: 24.5±3.6, healthy controls: 26.5±0.9; t=-2.985, P<0.01), more errors in object working memory (CID patients: 1.0 (0, 1.0), healthy controls: 0 (0, 0.3)), spatial working memory (CID patients: 3.0 (2.0, 4.0), healthy controls: 1.0 (1.0, 2.0)) and object recognition memory (CID patients: 0 (0, 0), healthy controls: 0 (0, 0); Z=-2.896、-5.007、-2.306, P<0.05), and lower serum BDNF (CID patients: (19.48±7.50) ng/ml, healthy controls: (46.49±13.33) ng/ml; t=-10.274, P<0.01) and GDNF (CID patients: (32.76±14.04) pg/ml, healthy controls: (59.63±20.30) pg/ml; t=-7.240, P<0.01). The partial correlation analysis showed that in the CID patients, the levels of BDNF and GDNF were correlated with PSQI scores negatively (r=-0.293, -0.320, P<0.05) and MoCA scores positively (r=0.331, 0.295, P<0.05). The BDNF level was also correlated with the duration of disease and the errors in the spatial working memory test negatively (r=-0.319, -0.393, P<0.05), and the GDNF level was correlated with the total sleep time detected with polysomnogram positively (r=0.520, P<0.05). Conclusion Serum BDNF and GDNF levels in CID patients were lower than those in healthy controls, and correlated with sleep quality and cognitive impairment.

Objective: To explore the application and effect of blended BOPPPS teaching mode in medical nursing teaching. Methods: A total of 80 nursing undergraduates of Grade 2014 in Hubei Medical University were divided randomly into teaching reform class and control class, with 40 students in each class. From February 2017 to July 2017, BOPPPS teaching was implemented in the teaching reform class, while traditional teaching was conducted in the control class. At the end of the experiment, Students in the two classes had questionnaire on the satisfaction of the teaching design, tests for self-learning ability and medical nursing level. SPSS 20.0 software was used for statistical analysis. Enumeration data between two classes were compared by chi-square test, while measurement data were compared by t test. Results: ①The number of students who were satisfied in the teaching reform class was 34 (85.0%), which was significantly higher than that of the control class (29, 72.5%). The difference has statistical significance. ② The self-learning dimensions and total score of the teaching reform class were (53.1±5.1), (52.4±4.8), (52.2±4.7), (51.9±4.7), (51.2±4.9) and (260.8±24.2), respectively, which were significantly higher than (48.6±4.3),(49.9±4.3), (49.7±4.1), (47.6±4.0), (47.1±3.9), and (242.9±20.6) of the control class. The differences were statistically significant (average P<0.05 or 0.01). ③The total scores (minutes) for regular assessments, theoretical examinations, and internal medicine education in the reform class were (26.1±2.3), (55.4±5.2), and (81.5±7.5) respectively, which was obviously higher than that(23.7±1.9), (52.6±4.6), (76.3±6.5) of the control class. The differences were statistically significant (average P<0.05 or 0.01). Conclusions The blended BOPPPS teaching focuses on the students, pays close attention to the students' attentiveness, participatory learning and goal achievement. This teaching model can improve students' satisfaction, self-learning ability and medical nursing study in a large extent.